<%@ page language="java" contentType="text/html; charset=UTF-8"
	pageEncoding="UTF-8"%>
<%@page import="com.jaxplat.commons.Row"%>
<%@page import="com.jaxplat.commons.RowImpl"%>
<%@page import="com.rs.commons.RsConstant"%>
<%
    String contextPath = request.getContextPath();
    Row dsInfo = new RowImpl();
    if (null != request.getAttribute("dsInfo"))
    {
        dsInfo = (Row) request.getAttribute("dsInfo");
    }
    java.util.List validateResult = null;
    if (null != request.getAttribute("validateResult"))
    {
        validateResult = (java.util.List) request.getAttribute("validateResult");
    }
    String idNo = (null == request.getAttribute("id_no")) ? "" : (String) request.getAttribute("id_no");
    // String idType= (null == request.getAttribute("id_type")) ? "" : (String)request.getAttribute("id_type");
    String applicantName = (null == request.getAttribute("applicant_name")) ? "" : (String) request.getAttribute("applicant_name");
    String gender = (null == request.getAttribute("gender")) ? "" : (String) request.getAttribute("gender");
    String mobileNo = (null == request.getAttribute("mobile_no")) ? "" : (String) request.getAttribute("mobile_no");
    String birthYear = (null == request.getAttribute("birth_year")) ? "" : (String) request.getAttribute("birth_year");
    String birthMonth = (null == request.getAttribute("birth_month")) ? "" : (String) request.getAttribute("birth_month");
%>
<!DOCTYPE html PUBLIC "-//WAPFORUM//DTD XHTML Mobile 1.0//EN" "http://www.wapforum.org/DTD/xhtml-mobile10.dtd">
<head>
	<meta name="keywords" content="<%=session.getAttribute("keywords")%>" />
	<meta name="description"
		content="<%=session.getAttribute("description")%>" />
	<meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
	<title>填写预约-云南移动无线城市</title>
	<link type="text/css" href="../css/wap.css" rel="stylesheet" />
</head>
<body>
<%=session.getAttribute("headerContentWeb")%>
	<div class="wap">
		<div class="navW">
			<div class="marginAout navIn">
				<span><a href="<%=contextPath%>/wap/index.jsp?portaltype=1&version=2&areacode=<%=session.getAttribute("areacode") %>">预约管理</a> </span><span
					class="current"><a
					href="<%=request.getContextPath()%>/wap/doctorAction.do?method=initSearch_s1">预约挂号</a>
				</span><span><a href="<%=request.getContextPath()%>/wap/guide.jsp?portaltype=1&version=2&areacode=<%=session.getAttribute("areacode") %>">用户指南</a>
				</span>
			</div>
		</div>
		<div class="bread_nav2">
			<div class="step">
				<span class="on">填写</span><span>→</span><span>确认</span><span>→</span>
				<span>支付</span><span>→</span><span>完成</span>
			</div>
		</div>
		<form name="form1" method="post"
			action="<%=request.getContextPath()%>/wap/reserve.do?method=confirm&portaltype=1&areacode=<%=session.getAttribute("areacode")%>&version=2">
			<div class="h_div">
				<h1 class="h1">
					预约基本信息
				</h1>
			</div>
			<div class="tab_containt">
				<p>
					<span class="span_b">专家名称：</span><%=dsInfo.getString("doctor_name")%>
					<input id="ds_id" name="ds_id" type="hidden"
						value="<%=dsInfo.getLong("ds_id")%>" />
					<input id="doctor_id" name="doctor_id" type="hidden"
						value="<%=dsInfo.getLong("doctor_id")%>" />
				</p>
				<p>
					<span class="span_b">专家职称： </span><%=dsInfo.getString("pro_title_name")%>
					<input id="pro_title" name="pro_title" type="hidden"
						value="<%=dsInfo.getString("pro_title")%>" />
				</p>
				<p>
					<span class="span_b">所属科室： </span><%=dsInfo.getString("sec_name")%>
					<input id="section_id" name="section_id" type="hidden"
						value="<%=dsInfo.getString("sec_name")%>" />
				</p>
				<p>
					<span class="span_b">医院名称：</span><%=dsInfo.getString("hos_name")%></p>
				<p>
					<span class="span_b">就诊时间：</span><%=com.jaxplat.util.DateUtils.parseDate(dsInfo.getDate("sc_date"))%>
					&nbsp;<%=dsInfo.getString("batch_name")%></p>
			</div>
			<div class="h_div">
				<h1 class="h1">
					患者基本信息
				</h1>
			</div>
			<div class="tab_content">
				<p>
					<span class="colorR">*</span>身份证号码：
				</p>
				<p>
					<input type="text" name="id_no" value="" maxlength="20" />
				</p>
				<p>
					<span class="colorR">*</span>患者姓名：
				</p>
				<p>
					<input type="text" name="applicant_name" maxlength="20" />
				</p>
				<p>
					<span class="colorR">*</span>性别：
				</p>
				<p>
					<input type="radio" name="gender" value="m" checked="checked"
						class="input_radio" />
					男
					<input type="radio" name="gender" value="f" class="input_radio" />
					女*
				</p>


				<p>
					<span class="colorR">*</span>住址：
				</p>
				<p>
					<input type="text" name="applicant_addr" maxlength="15" />
				</p>
			</div>
			<div class="h_div">
				<h1 class="h1">
					支付信息
				</h1>
			</div>
			<div class="tab_content">
				<p>
					支付方式：
					<select name="pay_type" style="width: 100px;">
						<option value="1" selected="selected">
							手机支付
						</option>
					</select>
				</p>
				<p>
					支付手机号：
					<%-- <%=request.getSession().getAttribute("mobile").toString()%>
					<input type="hidden" name="mobile_no" maxlength="11"
						value="<%=request.getSession().getAttribute("mobile").toString()%>" /> --%>
						<input type="text" name="mobile_no" value="" maxlength="11" value="<%=request.getSession().getAttribute("mobile") %>"></input>				</p>
				<p>
					<span class="span_b">挂号费：</span>
					<span style="color: #fc4519;">
					<%=com.rs.util.Utils.formatMoney(RsConstant.DOCTOR_FEE.getDouble(dsInfo.getString("pro_title")), "0.00")%>
					</span>元
				</p>
				<p>
					<span class="span_b">信息费：</span><span style="color: #fc4519;"><%=com.rs.util.Utils.formatMoney(RsConstant.RS_INFO_SERVICE_FEE, "0.00")%></span>元
				</p>
				<p class="text_center">
					<input name="submit" type="submit" value="提交预约" class="login_btn" />
				</p>
				<div style="color: #ff0000;">
					<%
					    if (null != validateResult && validateResult.size() > 0)
					    {
					        for (int i = 0; i < validateResult.size(); i++)
					        {
					%>
					<p><%=validateResult.get(i).toString()%></p>
					<%
					    }
					    }
					%>
				</div>
			</div>
		</form>
	</div>
<%=session.getAttribute("footerContentWeb")%>
</body>
</html>